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HomeMy WebLinkAboutUNDERGROUND TANK #1-C-03/20/87 FILE CONTENTS SUMMARY ENv. SENSITIVIrM: Activl~¥ Date # Of Tanks Comments / Bakersfield, California 93305 Leon M Hebertson, M.D. Telephone (805)861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reicherd March 24, 1987 U. S. Naval Reserve Center 4201 Chester Avenue Bakersfield, California 93301 Dear Lt. Warner: This is to advise you that this department has reviewed the project results for the fuel seepage investigation that was conducted at the U. S. Naval Reserve Center, 4201 Chester Avenue, Bakersfield, California. Based upon the laboratory results, this department is satisfied that the assessment is complete and no significant soil contamination resulting from fuel leakage exists at the site. Thank you for your cooperation in this matter. Sincerely, ~Lehman V Environmental Health Specialist Hazardous Materials Management Program JL:sw DISTRICT OFFICES Oelano . Lamont . Lake Isabel{e . Mo{ave . Rldgecreat Shafter . Taft i E'gI~RGENCY HAS STATE OFFICE OF EMERGENCY SERVICES ~T.ATE TANK tD ~ YES ~NO, REPORT BEEN FILED? ~ YES ~ NO REPORT DATE J LO=AL CASE # ' ~' REGIONAL BOARD CASE # ~ US EPA ID ~ REPnESENTING ~OCAL AGE"CY ~ OTHER CO"PANY OR AGENCY N~E ~ ~ ADDRESS ~ ~TREET CITY STATE ZIP FACILITY NAME (IF APPLICA'BLE) OPERATOR PHONE 327 j STREET CITY ZIP ~ CROSS S TREETi, -- I *Y'' OF A"EA ~EECIAL ~INDUSTRIAL I TYPE OF "US'NE~ 9 RE TA'~ FUEL STAT ID"I LOCAL AGENCy AGENCY NAME CONTACT PERSON PHONE ~ REGIONAL ~OARD =Z ( j o 'TscD ( ) CAS ~ (ATTACH EXTRA SHEET IF N~EDED) NAME QUANTITY LOST (GALLONS) ~ " DATE DISCOVERED I HOW DISCOVERED ~ iNVENTORY CONTROL '~ SUBSURFACE MONITORING ~m ~ DATE DISCHARGE BEGAN METHOD USED TO STOP DISCHARGE (CHECK ALL THAT APPLY) ~ "I M{ D{ D{ yl[ Y) ~UNKNOWN ~OVECONTENTS ~ REPLACE TANK ~ ~ HAS DISCHARGE BEEN STOPPED1 ~ REPAIR TANK ~ REPAIR PIPING ~ CHANGE PROCEDURES ~ SOURCE{S)~TANK LEAKOFDISCHARGE~KNOWN TANKS ON[Y/CAPACITY I~ .... GAL ~OVERFILLCAUSE{S) ~CORROSION < AoE I I I YRS. ~ UNKNOWN ~ATERIAL ~ RUPTURE/FAILURE ~ SPILL · U ~STEEL ~ FIBERGLASS ~ ~ OTHE~ {SPECIFY) ~ OTHER ~ UNKNOWN ~ OTHER RESOURCES AFFECTED WATER SUPPLIES AFFECTED THREAT- UN-- ~ OF ~ YES NO THREATENED UNKNOWN YES NO ENED KNQWN WELLS .~ SURFACE WATER OR STORM DeAl. ~ ~ ~ ,.DUSTRIA~ ~ ~ ~= BUILDING OR UTILITY VAULT ~ ~ ~ AGRICULTURAL ~ ~ ~ I GROUNDWATERr~E OZn o u. .ow. COMMENTS: COMPLETE AND ATTACH A CLEANUP TRACKING REPORT If ANY CLEANUP WORK OR PLANNING HAS STARTED dSC 05 (10/85} / Geotechnical and Environmental Consultants · Engineering and Chemical Laboratories March 17, 1987 Naval Marine Corp. Reserve Center 4201 Chester Avenue Bakersfield, CA 93301 Attn: Pettey Officer Ray Givens RE: Water Sampling and Analysis Naval Marine Corp. Reserve Center Bakersfield, California Dear Mr. Givens, In accordance with your request, Mr. Theodore Wright of our firm obtained a water sample on February 23, 1987, from the above-referenced site. The water sample was obtained in the area designated by yourself as the previous location of an underground tank and is shown on the attached site plan. The depth at which the water sample was obtained and the analysis performed on the sample ~t0~!/was set forth by Janet Lehman of the Kern County Health Department in '~~cussions with Mr. Theodore Wright of our firm. The water sample transported to our Fresno laboratory by Twining Laboratories, Inc. personnel. Please find enclosed results of the chemical analysis of the water sample, and a copy of our chain-of-custody form. Also enclosed is a copy of the boring log and site plan. Finally, we have attached our invoice for services performed for this project. ID 2527 Fresno Street · P.O. Box 1472 ID 9401 West Goshen Avenue Fresno, California 93716 · (209) 268-7021 Visalia, California 93291 · (209) 651-2190 ID 1405 Granite Lane, Suite 1 I 5301 Office Park Drive, Suite 310 Modesto, California 95351 · (209) 523-0994 Bakersfield. California 93309 ,(805) 322-5216 / Naval Marine Corp. Reserve Center March 17, 1987 Page 2 We appreciate the opportunity to be of service to you on this project. If you should have any questions regarding the information in this report, please call our office. THE TWINING LABORATORIES, INC. Theodore D. Wright, RCE #33710 (exp. 6-30-90) Engineering Manager Bakersfield Office RD/TDW/kl 3c: herewith lc: B F Fresno Modesto Visalia Bakersfield Sin;e 1898 Geotechnicaland EnvironmentaIConsultants · Engineering and Chemical Laboratories March 17, 1987 Examination #687-0794 Invoice # For: Naval Marine Corp Reserve Center 4201 Chester Ave Bakersfield CA 93301 ATTN: Petty Officer Ray Givens Sample: 1 water Received: 02-24-87 from Gary Kiger of Twining Labs Identification:Naval Reserve'Center TEST RESULTS Oil and Grease, mg/L ........................ *1 Lead, mg/L .................................. *0.005 Total Organic Halides (TOX), mg/L ............ 0.050 ~'~-'~. mg/L: milligram per liter *: less than TOX: The sample was centrifuged to remove sediment prior to analysis. THE TWINING LABORATORIES, INC. John Bricarello Chemistry Division JB:ja m3 2527 Fresno Street · P.O. Box 1472 [] 9401 West Goshen Avenue Fresno, California 93716 · (209) 268-7021 Visalia, California g3291 · (209) 651-2190 [] 1405 Granite Lane, Suite 1 [] 5301 Office Park Drive, Suite 310 Modesto, California 95351 · (209) 523-0994 Bakersfield, California 93309 .(805) 322-5216 PROJE. CT NO. '1 687-0794 :~ PAVEMENT .. :'- /SERVICE RACK OVER CONCRETE PAD /, //~, UNDERGROUND TANK LOCATION :~. ./ ' / '.-'i-'~'"',- :' :'dj '- 5~AREHOUSE BUILDING : DATE: NAVAL ~RINE CORP. RESERVE CENTER N~S ~-~-R* ~ The Twining BAKERSFIELD CALIFORNIA DRAWN BY: APPROVED BY: , ~. ] L~bor~tories, Inc. DRAWING No. FR ESNO/MOOES TO/Vi 1 of 1 i -- LOG OF BORING ~ IIII I I II PROJECT: .NAVAL MARINE CORP. RESERVE CENTER HOLE ~' : I I B-- ] BAKERSFIELD, CALIFORNIA SHEET NO' 1 OF 1 JOB NO: 687--0794 LOCATION: SEE SITE MAP DRILL TYPE: B--40 DRILLED BY: T' Conley LOGGED BY:T. Wright -'LEVATION: TOP OF HOLE: -- FT. REMARKS: GROUNDWATER: -7.0 FT )ATE: STARTED: 2-23-87 COMPLETED: 2-23-87 I III III I D z .~ -- aI PERCENT ~ROPERTIES: ~ CLASSIFICATION AND DESCRIPTI'ON --o'--~"'' z'-. i~ :: ~- ,-,~ I'"~-i ~-- x I%~TAINED rEST, TYPE AND - SAND, Silty; moist, fine to medium grained, brown (SM) 5-- ~ G.W.L. 2-23-87 10 -- W Water _ sample obtained - at -10.0ft ._ Bottom of Boring The Twining Laboratories, Inc. VlJalla Fresno Mode#to Bakersfield The Twining LaboratorieS, Inc. CHAIN OF CUSTODY RECORD ProjectN©. ,.~'~-~..'/ ~.~.f'~,,V~, ~.~_.~.[.~.i~~- Affiliation of Sampler/Shipper ~' ~ '~' ~~- Zip Telephone Number Street_ _ ~ ~ity / ~ ~ Signature '"'" Transported By ~'~"~. ~-'~'G'~'~'~% Date Shipped Address ~~/ ~' Date/Time Received Comments Collector's Sample No. Sample Description Analysis Requested l.~~~ o,~ ~ ~,~,-~ ~o~ L~4 Chain of Poss~sio~rt~..../~ 1.._m~x K.,~-~ 7~,",.~'~.~ 'z.~.~ ~ Signatur~ ~filiation I IncluSive ~ates ~~ ~~~ . ,, ., ~/~,~ /~ ~ ~ - ~i~n~ure ~ Affiliation ~ IncluSive Dates - ~,gna~' ~ . Affilia~ ~ Inclusive Dates ' - - Signature [ v .- A~filiati~n / ,nclusiveDate~ 1700 Flower Street N COUNTY HEALTH DEPARTME HEALTH OFFICER Bakersfield, California 93305 Leon M Hebertson, M.D. Telephone (805)861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard March 16, 1987 Lt. Warner Naval Corps Reserve Center 4201 Chester Avenue Bakersfield, California 93301 Dear Lt. Warner, This department has not yet received the water sampling proposal for the U. S. Naval Reserve Center in Bakersfield, California. I have contacted Lt. Bustamante and he informed me that you have accepted a bid. I have tried several times to contact you regarding this matter, it is imperative that you submit a copy of the proposal immediately. If you have any questions, please call me at (805) 861-3636. Sincerely, Janis ~ehman Environmental ~ealth Specialist ~azardous Materials Management Program JL:sw DISTRICT OFFICES Delann . Lamont . Lake Isabella . Motave K~t~ COUNTY HEALTH DEPARTMEI 1700 Flower Street HEALTH OFFICER Bekertfleld, California 93305 ENVIRONMENTAL HEALTH DIVISION Leon M Hel=ert.on, M.D. Telephone (805) 861-3636 DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard January 15, 1987 Lt. Bustamante Commander, Naval Reserve Ready Command Building 1 Naval Station Treasure Island San Francisco, California 94130-5032 Re: Underground Tank Abandonment at the Bakersfield Naval Reserve Center Dear Sir: This letter will follow-up our telephone conversation of January 9th, 1987, in which an extension was given for the submittal of a water sampling proposal for the U.S. Naval Reserve Center on Chester Avenue in Bakersfield, California. The proposal must be submitted to this~ office within 30 days from the date of our telephone conversation. If you have any further questions, please call me at (805) 861-3636. Sincerely, Environmental Health Specialist Hazardous Materials Management Program~ JL:sw cc: U.S. Naval Reserve Center, Bakersfield, California DISTRICT OFFICE8 1700 Flower Street COUNTY HEALTH DEPARTMEN * HEALTH OFFICER Bakersfield, California 93305 Leon M Hebertaon, M.D. Telephone (805)861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Reichard December 18, 1986 U. S. Naval Corps Reserve Center 4201 Chester Avenue Bakersfield, California 93301 Attn: Lt. H. G. Warner, USNR Dear Lt. Warner, This letter will follow-up the telephone conversation that you had with Ann Boyce, December 10, 1986, regarding the required water sampling necessary to to complete the underground tank abandonment at the U.S. Naval Reserve Center on Chester Avenue in Bakersfield, Caltfornia~ You stated during this conversation that it would take between 2- 4 weeks to get approval for the monies necessary for this project. The proposal for the sampling must be submitted to the Health Department within six weeks from the date of the December 10, 1986 phone call. If you have any further questions, please call me at (805) 861- 3636. Sincerely, , /// Janis Lehma~ U ~~ental Health Specialist Hazardous Materials Management Program JL:sw DISTRICT OFFICES la~hall~ ~dl~l~l~l~ Rldaecra~t . Shafter . Taft ~?OOF~owerStreet K IEFII COUNTY HEALTH DEPARTMENT HEALTHOFF~CER Bakersfield, California 93305 Leon M Hebertaon, M.D. Telephone (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S, Relchard November 26, 1986 Naval Corps Reserve Center 4201 Chester Avenue Bakersfield, California 93301 ATTN: Sr. Chief Blue Dear Sir, We received a copy of the total organic halogens analysis that was run on the soil samples taken from below the underground tank that was abandoned in August, 1986. As stated in the letter to you, August 21, 1986, and November 4, 1986, water samples taken through approved methods, and analyzed for oil and grease, lead, and total organic halides, will be necessary. An environmental-assessment contractor will be necessary to develop the proposal for this type of water sampling. The deadline for the submittal of the proposal is December 8, 1986, 30 days from your receipt of the letter this office sent to you November 4, 1986. Sincere/y, Environmental Health Specialist I Hazardous Materials Management Program JL:sw DISTRICT OFFICES I~el~nn . I.am~nt . Lake IRabella . Molave . Rldqecrest . Shafter . Taft LABORATORIES J. J. EGLIN, REG. CHE/qA. E~~ PETROL~U~ 4100 PIERCE RD., BAKERSFIELD, CALIFORNIA Y~avo ,- U. S. Naval Reserve Center Date Reported: 11/17/86 Commanding Officer Date Received: 9/8/86 4201 Chester Avenue Laboratory No.: 16028, 16029 Bakersfield, California 93301 Constituents ~ Soil #1 Soil #2 @ 2' 4' to 4½' Oil ~ Grease, mg/kg 20. 20. Total Lead, mg/kg 2.01 (-) 2.0 TOX (Total Organic Halogens), mg/kg (-) 20. (-)2'0. (-) refers to "less than". B C LABORATORIES. INC. ,?00F,o.erS,.ee, iON COUNTY HEALTH DEPARTMEO HEALTHOFF,CER Bekerafleld, California 93305 ENVIRONMENTAL HEALTH DIVISION Leon M Heberlaon, M.D. Telephone (805) 861-3636 DIRECTOR OF ENVIRONMENTAL HEALTH Vernon S. Relchard November 4, 1986 Naval Corps Reserve Center 4201 Chester Avenue Bakersfield, California 93301-1198 RE: UNDERGROUND TANK ABANDONMENT. Dear Sr. Chief Blue, The laboratory results received October 31, 1986 were incomplete. The permit specified that the samples were to be analyzed for Oil and grease, lead, and total organic halides. The results do not showthat the test for total organic halides w~s run. It will be necessary to have analysis results of soil samples for total organic halides taken at depths of two feet and six feet below the tank bottom. The results must be submitted to this office within three days of sample analysis completion. As stated in a letter to you August 21, 1986 water samples taken through approved methods and analyzed for oil and grease, lead, and total organic halides will be necessary. You have 30 days in which to submit a proposal to this department that outlines the sampling procedure that will be utilized to retrieve the necessary samples. If you have any questions please call me at (805) 861-3636. Sincerely, JanisLehman Environmental Health Specialist I Hazardous Materials Management Program JL:sw DISTRICT OFFICES Delano . Lamont . Lake laabella . MoJave . Rldgecrelt . Shifter . Tiff ..,-,..,...,..,. ATORIES J I [GLIN. IlIG CHIM INGII ~(rROZ~UM MAIN OFFICE 4100PIERCE ROAD BAKERSFIELD CA 9330ePHONE 327-491 U.S. Naval Reserve Center 'Date Reported: 9/26/86 Commanding Officer Date Received: 9/8/86 4201 Chester Avenue Laboratory No.: 16028 - 16029 Bakersfield, California 93301 Sample Description: #1 - 2' #2 - 4' - 4%' #1 #2 Oil & Grease, mg/kg 20. 20. Total Lead, mg/kg 2.01 (-) 2.0 (-) refers to "less than". B C LABORATORIES, INC. BY~ 1100 Flower Streel COUNTY HEALTH DEPARTMEt~I~~ HEALTH OFFICER 6etmrtlleid, California 93305 Leon M Heberllon, M.D. Telephone (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION DIRECTOR OF ENVIRONMENTAL HEALTH .~'~~'. Vernon S. Relcherd August 21, 1986 Naval Corps Reserve Center 4201 Chester Avenue Bakersfield, California 93301-1198 ATTN: Sr. Chief Blue Dear Sir: This is written notification that further assessment is required for the site where the underground tank was removed August 15, 1986. The presence of groundwater at approximately 10 feet in your area had not been previously verified. In cases where groundwater is known to be high a test boring is done to determine the exact level of the water table. If the water table is low then soil samples are taken fOr the preliminary assessment. But in cases where the water table is high, as was found at the Naval Reserve Center, the preliminary assessment also consist of water sampling done through developed wells. An environmental assessment contractor will be necessary to develop the proposal for this type of water sampling. If you would inform me as to the environmental assessment contractor you choose I will then address further questions regarding this matter to them. If you have any further questions regarding this matter please contact me at (805) 861-3636. Sincerely'~Ou~-~ Janis Lehman Environmental Health Specialist I Hazardous Materials Management Program JL: sw DISTRICT OFFICES Oelano I.nmont . I. eke Ilahella Mnlave . Rldflecrellt . Rhaft.r . Taft 1700 Flower Slree! COUNTY HEALTH DEPARTM~.~I~ HEALTH OFFICER Bekerlfle;d, California 93306 Leon M Hebertaon, M.D. Telephone (805) 861-3636 ENVIRONMENTAL HEALTH DIVISION ~/~~ DIRECTOR OF ENVIRONMENTAL HEALTH Vernon 8. Relchard PERMIT FOR TEMPORARY OR PERMANENT PERMIT NUMBER A221-06 CLOSURE/ABANDONMENT OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY ..- FACILITY NAME/ADDRESS: OWNER(S) NAME/ADDRESS: CONTRACTOR: U.S. NAVAL RESERVECENTERBAKERSFIEID Commanding Officer RMCB 17 DET 0717 4201 Chester Avenue U.S. Naval Reserve Center U.S. Navy Reserve Bakersfield, CA 93301 4201 Chester Avenue Bakersfield, CA 93301 PERMIT TO ABANIX)N PERMIT EXPIRES 8/15/87 1 TANK (S) AT APPROVAL DATE 8/15/86 ....................................... POST ON PREMISES ........................................ CONDITIONS AS FOLI/~S: * 1. Permittee must notify Kern County Fire Department (805-861-2577) 48 Hours prior to initiating abandonment action. 2. Abandonment must be per approved methods as described in permit application and Fire Department Handout. 3. All procedures used must bein accordance with requirements of Standards and Guidelines develo.p~d for implementation of Kern County Ordinance Code. A copy of these requirements are enclosed with this permit. 4.A minimum of two samples must be retrieved beneath the center of the tank at depths of approximately 2' and 6'. 5. A minimum of two samples must be retrieved at depths of approximately 2' and 6' for every 15 feet of pipe run. 6.All samples must be analyzed for oil, grease extraction, lead, and total organic halides. 7. Advise this off/~ceof the time and date of proposed sampling with 24 hours advance notice. Accepted By , Dat . DISTRICT OFFICES Delano . Lamont . Lake laabelle . Molave . Rldgecrelt . 8heft~ . Taft Division of Enviro~ental it Appl Lcation Date 6I~la~ 1700 Flower Street, Bakersfield, CA 93305 No. of Tanks to ~ ~ndoned ~ APPLICATION FOR PERMIT FOR TEMPORARY OR PERMANenT CLOSURE/A~ANI~M~T OF UNDERGROUND HAZARDOUS SUBSTANCES STORAGE FACILITY T_~ o_~f A~plication (Fill Out On__e Application Per Facility_~) []Temporary Closure/Abandonment[] Permanent Closure/Abandonment A. Project Contact (name, area code, phone): Days 327-7194 Nights 327-7195 Facility Name U.S~ NAVAL RESERVE CENTER BAKERSE]JEL~D Facility A~dreSS 4201 CHESTER AVE. ~BAKER~F~ED,CA. Nearest Cross St. COLUMBUS AVE. T R SEC (Rur'al' 'Locations Only) Owner COMMeNT)INK ~)f_FT_CFR IJ.K.. NA_VAt RFSFRVE C~NTERTele[~hone 327-7194 A~dress 4201-'CHESTER AVE. ,BAKERSFIELD,CA. . Zip . 93301 _.. Operator U.S. NAVA&. RESERVE CENTER Telephone '327-7195 -- Address 4201 CHrSTFR AVF.?RALFRKFI~LD,CA; .... / ~ ZiP 93301 B. Water to Facility Provided by CALIF. WATER' CO. Depth to Groundwater UNKNOWN Soil Characteristics at Facility UNKNOWN Basis for Soil Type and Groundwater Depth. Determinations UNKNQ~]N C. Tank Removal ContractorRMCB 17 DET 0717 ,U.S. NAVY RESER~ License No. Address 4201 C~ESTER AV&,BAKhKxti~_LD LA. z'i~ ~ddUl Telephone Proposed Starting Date 6/1~/66 . . , Proposed Completion Date Worker's Cc~apensation Certification '~' Insurer Environmental Assessment Contractor SAME CA License No. Address Zip Telephone Proposed Starting Date Proposed Ccmpletion Date Worker's Compensation Certi"fi'ca~tion ~ Insurer D. Chemical Composition of Materials Stored Tank ~ Chemical Stored (non-con~ercial name) Dates Stored Chemical Previously Stored : (if different) i ASSORTED MOTOR OILS -- to8/7/86 , N/A to to to E.Describe Method for Retrieving Samples DRILL AND AUGER samples Will be Analyzed for 0IL C08TAMINATION 0F ~0IL Laboratory That Will Perform Analyses of Samples '8C tABORITORY Addr.~ss 4100 PIERCE ROAD,BAKERSFIE.LD:C.ALIF. 9330~ Tel~pj~6ne ~P7-q/%Pq F. This application for: j~]Jremoval or Oa~ndonment in place * * PLEASE PROVIDE INFORMATION REQUESTED GN REVERSE SiDE OF THIS SHEET BEFORE SUBMI~i'ING APPLICATION FOR REVIEW. ) tlh~.s form has b~er~ c~pleted under penalty of perjury and to the best of my knowledge is true nature H.~G. WARNER Title COMMANDING OFFICENDate 8/15/86 ~rn Count¥.Heal~:h Department Permit No., ~ I~ivision of Environmental Health Application Da~ V ~ i700 Flower Street, Bakersfield, CA 93305 -- ~ vv~ ,~vv -- APPLICATION FOR PERMIT TO OPERATE UNDERGROUND HAZA~DfX3S SUBSTANCES ST~3RAGE FACILIT~ 7%ype of appl .i. cat ion (check): []New Facility r']Modification of Facility [9~Extsting Facility r~ansfer of Ownership A. Emergency 24-Hour Contact (nMe, area code, phone): Days {.Duty} {&05}-3P7-7%9g Nights Lt. Warher Facility Name N&MCRTC, BAKERSFIELD, CALIFORNIA No. of Tanks one Type of Business (check)': ~]Gasoline ~t~tion ~other (describe) Militaey Is Tank(s) Located on an Agricultural Farm?. r'~Yes ~No Is Tank(s) Used Primarily for ~gricultural Purposes? E]Yes X~](No Facility Address q~D1 {he~.t.~p Ave. Nearest Cross St. folumbus T R SEC (Rural Locations Gnly) Owner ~.-~. NAVY Contact Person Lt. ~aPneP ~ddress g~D~, £heste~ AVE ... ZIp~33B% Telephone Operator N/~ .... Contact Person Addr ess Zip Telephone B. Water to Facility Provided by £ali. ~ateP SePvice Depth to Groundwater UNK Soil Characteristics at Facility UNK Basis for Soil Type and Groundwater Depth 'Determinations UNK '. Contractor N/A CA Contractor's License No. Addr ess Zip Telephone Proposed-starting Date Proposed Ccmpletion Date Worker's Ccmpensation Certification ! Insurer ). If This Permit Is For Modification Of An Existing Facility, Briefly Describe Modifications Proposed N / A :. Tank(s) Store (check all that apply): Tank ! Waste Product Motor Vehicle Unleaded Regular Premt~ Diesel Waste [] [] ° [] B B B [] [] [] [] ' Ch~ical C~positiom of Materials S~orea (not necessary for motor ~ehicle f~els) Tank ~ Chemical Store~ (non-co~ercial ~e) ~ ~ (if know~) ~bemical Previousl~ Stored (if dt f'£erent) Transfer of Ownership Date of ~ns~er N/A Previous Owner Previous Facility Name I, accept fully all ~l'ig-ations of Permit No. ~ issued to · I understand that the Permitting Authority may review and ,x~ify or termi'na~e the transfer of the Permit to Operate this ~dergro~d storage facility u~n receiving this c~pleted form. 3hiStrue a~f°mcorrg.~ v!-~-~-.has^k~e~ ~,:~pleted~[A~ under penalty of perjury and to the best of my knowledge is Signature _~/~. TitleCOMMANDING {LT}Date 21JUL86 Facility Name... N&~CRTO...~.BA~f~~ ~~(~ ,F Permit No. TANK ~ l, (FILL OUT .~EPARATE FORM FOR EAC~ TANK) F~R-EACH SECTION, CHECK ALL APPI~OPI~IATE BOXES H. 1. Tank is: ~lVaulted ['lNon-Vaulted ~]Double-Wall [')Single-Wall 2. ~ Material  Carbon Steel F] Stainless Steel ~lPolyvinyl Chloride []Fiberglass-Clad Steel Fiberglass-Reinforced Plastic [] Concrete [] Al~m~in~n [] Bronze ~nknown Other (describe) 3. Primary Containment Date Installed J Thickness (Inches) Capacity (Gallons) Manufacturer UNKNOWN UNKNOWN UNKNOWN UNKNOWN 4. Tank secmond'ar¥ cor{tair~nent []Double-Wall ~l Synthetic Liner []Lined Vault []None ~lUnknown []Other (describe): Manufacturer: ~lMater ial Thickness (Inches) Capacity (Gals.) 5. Tank Interior 'Lining -- [[]Rubber F1Alkyd FIEpaxy [[]Phenolic [[]Glass ~lClay [[]Unlined ~UnknOw~ [[]Other (describe): 6. Tank Corrosion Protection --l~Galvanfzed "~-~---~ass-Clad []E~l~thylene Wrap ~lVinyl Wrappin~ OTar or Asphalt ~Unknown [[]None OOther (describe): Cathodic Protection: [.']None []Impressed Current System ~SaCrific'ial ~qo~e' System I)escrfbe System & Equipment: 7. Leak Detection, Monitor. in~, and Intercept. ion a. Tank: [][]Visual (vaulted tanks only) FI Groundwater Monitorfrg' Well(s) []Vadose Zone Monitoring Well(s) ['lU-Tube Without Liner []U-Tube with Cc~patible Liner £)irecting Flow to Monitorirg Well(s)* [] Vapor I~etector~ [] Liquid Level Sensor~ [] Conductivity Sensor~ [] Pressure ~ensor in Annular Space of Double Wall Tank' [] Liquid I~etrieval & Inspection From U-Tube, Monitoring Well or ~nnular S~ace []Daily Ga~ging & Inventory Reconciliation n periodi¢ Tightness Testing [] None[]Unknown [] Other b. Piping: ffTFlow-Restricting Leak Detector(s) for Pressurized Piping= O Monitoring S~np with I~ace~y O Sealed Concrete Race~y OHalf-Cut Compatible Pi~e Raceway OSynthetic Liner Raceway rX1None [] Unknown [] Other ~Describe Make & Model': ___',_ __._~____ 8. ~en Tightness Tested? []Yes ~lNo []Unknown Date of Last Tightness Test Results of Test Test Name Testing Ccmpany 9 Tank Repa ir l~e~ai fed? []Yes [~lNO W1Unknown Date(s) of Repair(s) Describe Repairs 10. Overfill Protection ~--Operator ~iils, Controls, & Visually Monitors Level []Tape Float Gauge F1Float Vent Valves [-]Auto Shut- Off Controls []Capacitance Sensor []Sealed Fill Box ~XINOne Flt]nknown []Other: List Make & Model For Above Devices 11. Piping a. Underground Piping: []Yes F']No [~Unknown Material Thickness (inches) Diameter Manufacturer ['lPressure []Suct['On []Gravity Approximate Length of Pipe b. Underground Piping Corrosion Protection : OGalvanized []Fiberglass-Clad []Impressed Current []Sacrificial Anode [']Polyethylene Wrap []Electrical Isolation []Vinyl Wrap []Tar or Asphalt []Unknown ~lNone []Other (describe): c. Underground Piping, Secondary Containment: I-]Double-Wall []Synthetic Liner ~/$! ~m ~A~None []Unknown ti. Other (describe):